When prescription drugs are combined with other substances (called polysubstance use), there are high chances of something going wrong. One such class of drugs is benzodiazepines, also known as “benzos.” Though benzos can be safely used on their own and under a doctor’s care, they can be dangerous when mixed with alcohol. A 2019 study found that patients with alcohol use disorders (AUD) or unhealthy alcohol use had much higher odds of concurrent (at the same time) benzo use than low-risk drinkers.1 Past studies have also indicated that alcohol may be involved in more than 1 in 5 of benzodiazepine-related deaths that happen in U.S. emergency rooms. 1,2 The interaction of these two substances can lead to dangerous central nervous system (CNS) depression in such a way that smaller amounts become more lethal.2 Read on to learn more about the dangers of mixing benzos and alcohol. Dangers of Mixing Benzos with Alcohol Benzodiazepines and alcohol are both central nervous system (CNS) depressants. CNS depressant drugs increase the activity of a brain chemical known as GABA, which essentially inhibits (slows) certain types of brain activity.3 This can lead to calming and drowsy (sedative) effects, which is why benzos are used to treat anxiety disorders.3 Combining benzos with alcohol can intensify their sedating effects, which can lead to problems such as:1,2,5,6,13 Over-sedation or extreme drowsiness. Dizziness. Slowed reaction times and trouble with movement. Falls and other injuries. Memory problems. Worsened mental health issues such as depression and anxiety. Increased risk of addiction development. Trouble breathing. Increased risk of overdose. How to Manage Benzodiazepine and Alcohol Withdrawal Benzodiazepine withdrawal symptoms are similar to alcohol withdrawal symptoms.7 However, regular use of both substances may be associated with increased withdrawal severity and more risk of withdrawal complications such as seizures .7 Signs and symptoms associated with both alcohol and benzo withdrawal include:7 Sweating. Fast heart rate. Trouble falling or staying asleep. Feeling sick to the stomach and vomiting. High anxiety. Hallucinations (seeing, feeling, or hearing things that are not there). Tremors (shakiness). Seizures. Psychomotor agitation (restlessness; purposeless, uncontrollable body movements) Delirium (sudden, severe confusion). Left unmanaged, some of these symptoms can be fatal.8 For safety reasons, the Substance Abuse and Mental Health Services Administration (SAMHSA) advises some form of 24-hour medical care for those detoxing from benzos or alcohol.8 But the exact level of care and treatment plan will depend on your age, how much of each substance you use, which benzo you use, how long you’ve been using, and if you’ve been through withdrawal before.8 Can You Die from Mixing Alcohol and Benzos? [callout-complex title="Common Benzos" position="right"] Alprazolam (Xanax) Lorazepam (Ativan) Clonazepam (Klonopin) Diazepam (Valium) [/callout-complex] Mixing benzodiazepines and alcohol can be fatal. In fact, a 2010 study found that roughly 4 in 20 benzo-related deaths also involved alcohol.9 Taking benzos by themselves do not usually lead to death, but your risk of death is higher when used with alcohol.10 Combining alcohol with a benzos can result in severe or life-threatening symptoms such as:7 Low breathing rate (respiratory depression). Elevated heart rate. Hallucinations. Seizures. Delirium. In general, hallucinations, delirium, and seizures can increase the risk of accidents, injury, and death.8 Mixing alcohol with benzos may also increase your risk of severe injury from car accidents, a risk that’s specifically higher when the two are mixed versus when they are used alone.12 Finding Treatment for Benzodiazepine and Alcohol Withdrawal If you’re using benzos and alcohol together and are ready to quit, talk to a doctor or other healthcare professional. They can help you find treatment that fits your needs. A professional medical detox program can help keep you safe and more comfortable during withdrawal.8 American Addiction Centers is a leading provider of detox and rehab, with locations across the nation. Call our detox hotline at [phone] to talk to one of our compassionate admissions navigators any time, day or night, or get started online with the form below. [vob] [sources-default] Hirschtritt, M.E., Palzes, V. A., Kline-Simon, A. H., Kroenke, K., Campbell, C. I., & Sterling, S. A. (2021). Benzodiazepine and unhealthy alcohol use among adult outpatients. The American Journal of Managed Care, 25(12), e358–e365. Schmitz, A. (2016). Benzodiazepine use, misuse, and abuse: A review. Mental Health Clinician, 6(3), 120–126. National Institute Drug Abuse. (2018, March 6). Prescription CNS depressants DrugFacts. Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152–155. Weathermon, R., & Crabb, D. W. (1999). Alcohol and medication interactions. Alcohol Research & Health, 23(1), 40–54. Votaw, V. R., McHugh, R. K., Vowles, K. E., & Witkiewitz, K. (2020). Patterns of polysubstance use among adults with tranquilizer misuse. Substance Use & Misuse, 55(6), 861–870. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment. Jones, C. M., Paulozzi, L. J., & Mack, K. A. (2014). Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths—United States, 2010. MMWR Weekly, 63(40), 881–885. Kang, M., Galuska, M., & Ghassemzadeh, S. (2021, July 26). Benzodiazepine toxicity. Sachdeva, A., Choudhary, M., & Chandra, M. (2015). Alcohol withdrawal syndrome: Benzodiazepines and beyond. Journal of Clinical and Diagnostic Research, 9(9), VE01–VE07. Movig, K.L.L., Mathijssen, M.P.M., Nagel, P.H.A., van Egmond, T., de Gier, J.J., Leufkens, H.G.M., & Egberts, A.C.G. (2004). Psychoactive substance use and the risk of motor vehicle accidents. Accident Analysis & Prevention, 36(4), 631–636. National Institute on Alcohol Abuse and Alcoholism. (2020, November). Harmful interactions: Mixing alcohol with medicines. [/sources-default] ...